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Rett SyndromePhase 3NCT04181723

Study of Trofinetide for the Treatment of Girls and Women With Rett Syndrome (LAVENDER™)

A Phase 3 study testing Trofinetide in people with Rett Syndrome, run by ACADIA Pharmaceuticals Inc. at 21 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

To investigate the efficacy of treatment with oral trofinetide versus placebo in females with Rett syndrome Read more about this study

Who is it for?
Ages 5 to 20 years, women only
Conditions the study is for
Rett Syndrome
What is being tested?
Trofinetide
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
187 participants
Where
21 sitesUnited States
Study dates
6 Nov 2019to 28 Oct 2021
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 5 to 20 years
  • Women only
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Female subjects 5 to 20 years of age, inclusive, at Screening
  • Body weight ≥12 kg at Screening
  • Can swallow the study medication provided as a liquid solution or can take it by gastrostomy tube
  • Has classic/typical Rett syndrome (RTT)
  • Has a documented disease-causing mutation in the MECP2 gene
  • Has a stable pattern of seizures, or has had no seizures, within 8 weeks of Screening
Show all 9Show fewer
  • Subjects of childbearing potential must abstain from sexual activity for the duration of the study and for at least 30 days thereafter or must agree to use acceptable methods of contraception. Subject must not be pregnant or breastfeeding.
  • The subject's caregiver is English-speaking and has sufficient language skills to complete the caregiver assessments
  • Subject and caregiver(s) must reside at a location to which study drug can be delivered and have been at their present residence for at least 3 months prior to Screening

Who cannot join

  • Has been treated with insulin within 12 weeks of Baseline
  • Has current clinically significant cardiovascular, endocrine (such as hypo- or hyperthyroidism, Type 1 diabetes mellitus, or uncontrolled Type 2 diabetes mellitus), renal, hepatic, respiratory or gastrointestinal disease (such as celiac disease or inflammatory bowel disease) or has major surgery planned during the study
  • Has a history of, or current, cerebrovascular disease or brain trauma
  • Has significant, uncorrected visual or uncorrected hearing impairment
  • Has a history of, or current, malignancy
  • Has a known history or symptoms of long QT syndrome
  • Additional inclusion/exclusion criteria apply. Patients will be evaluated at screening to ensure that all criteria for study participation are met. Patients may be excluded from the study based on these assessments (and specifically, if it is determined that their baseline health and condition do not meet all pre-specified entry criteria).

Trial locations and contacts

21 sites in 1 country.

21 sites in 1 country

United States21 sites
  • Emory Genetics Clinical Trial Center

    Atlanta, Georgia, 30322

  • Children's Hospital Colorado

    Aurora, Colorado, 80042

  • Kennedy Krieger Institute - Clinical Trials Unit

    Baltimore, Maryland, 21205

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35233

  • Boston Children's Hospital Harvard Medical School

    Boston, Massachusetts, 02115

  • The University of North Carolina at Chapel Hill

    Chapel Hill, North Carolina, 27599

  • Rush University Children's Hospital

    Chicago, Illinois, 60612

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • Greenwood Genetic Center

    Greenwood, South Carolina, 29646

  • Texas Children's Hospital

    Houston, Texas, 77030

  • University of California, San Diego

    La Jolla, California, 92093

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Translational Gemomics Research Institute (TGen)

    Phoenix, Arizona, 85012

  • UC Davis MIND Institute

    Sacramento, California, 95817

  • Gillette Children's Specialty Healthcare

    Saint Paul, Minnesota, 55101

  • Seattle Children's

    Seattle, Washington, 98105

  • Washington University School of Medicine

    St Louis, Missouri, 63110

  • Children Medical Services

    Tampa, Florida, 33606

  • Montefiore Medical Center, Children's Hospital at Montefiore

    The Bronx, New York, 10467

Other trials in United States

About this study

Official title: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study of Trofinetide for the Treatment of Girls and Women With Rett Syndrome

To investigate the efficacy of treatment with oral trofinetide versus placebo in females with Rett syndrome

Conditions
Rett Syndrome
Being tested
Trofinetide, Placebo
Medical subject headings
Rett Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TrofinetideDrug

    Trofinetide solution administered based on the subject's weight at Baseline, twice daily for 12 weeks

  • PlaceboOther

    Trofinetide placebo solution administered based on the subject's weight at Baseline, twice daily for 12 weeks

Study groups in NCT04181723
Study groupRoleWhat they receive
Drug - TrofinetideExperimentalTrofinetide solution of 30-60 mL based on the subject's weight at Baseline, administered twice daily by mouth or gastrostomy tube (G-tube)
Receives: Drug: Trofinetide
PlaceboPlacebo comparatorTrofinetide placebo solution of 30-60 mL based on the subject's weight at Baseline, administered twice daily by mouth or gastrostomy tube (G-tube)
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rett Syndrome Behaviour Questionnaire (RSBQ) Total Score - Change From Baseline to Week 12

    The RSBQ is a 45-item caregiver-completed rating scale that includes 45 items, 39 of them grouped into 8 subscales, whose ratings reflect the severity and frequency of symptoms. Items are rated as 0 (not true), 1 (somewhat or sometimes true), or 2 (very true). The 8 subscales are general mood, breathing problems, hand behavior, face movements, body rocking/expressionless face, night-time behaviors, fear/anxiety, and walking/standing. Scores for item 31 are reversed in the calculation of the total score. The total score ranges from 0 to 90 and is calculated as the sum of the item scores. Higher scores mean worse behaviour.

    Measured: Baseline and Week 12

  2. Clinical Global Impression-Improvement (CGI-I) Score at Week 12

    To rate how much the subject's illness has improved or worsened relative to a baseline state, a 7-point scale is used from 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse.

    Measured: 12 Weeks Treatment Duration

Secondary outcomes (9)
  1. Change From Baseline to Week 12 in Communication and Symbolic Behavior Scales Developmental Profile™ Infant-Toddler Checklist - Social Composite Score (CSBS-DP-IT Social)

    Standardized screening scale for assessing communication and pre-linguistic skills in young children 12-24 months and can be used with older children with developmental delay. The CSBS-DP includes a suite of three separate measures: The Infant-Toddler Checklist, a follow-up Caregiver Questionnaire and a Behavior Sample. In this study only the Infant-Toddler (CSBS-DP-IT) Checklist was used. The CSBS-DP-IT Checklist is a 24-item rating scale and each item is scored using a three-level rating of frequency: "not yet", "sometimes" and "often". The CSBS-DP-IT Social Composite score the range was 0 to 26 and a higher score represented a worse outcome. Three composite scores can be calculated: 1) Social Composite; 2) Speech Composite; 3) Symbolic Composite.

    Measured: 12 Weeks Treatment Duration

  2. Change From Baseline to Week 12 in Impact of Childhood Neurologic Disability Scale (ICND) Total Score

    The Impact of Childhood Neurologic Disability (ICND) scale evaluates the effect of four conditions or health problems on 11 aspects of a child's or family's life as "A lot", "Some", "A little", "Not at all", or "Does not apply". The four conditions or health problems are 1) inattentiveness, impulsivity, or mood, 2) ability to think and remember, 3) neurologic or physical limitations, and 4) epilepsy. The ICND score the range of 0 to 132 and a higher score represents a worse outcome.

    Measured: 12 Weeks Treatment Duration

  3. Change From Baseline to Week 12 in Rett Syndrome Clinician Rating of Hand Function (RTT-HF)

    Clinical assessment of the subject's ability to use their hands for functional purposes (such as reaching for and grasping objects, self-feeding, or drawing). The assessment is made on an 8-point Likert scale (0-7) with 0 denoting normal functioning and 7 the most severe impairment.

    Measured: 12 Weeks Treatment Duration

  4. Change From Baseline to Week 12 in Rett Syndrome Clinician Rating of Ambulation and Gross Motor Skills (RTT-AMB)

    Clinical assessment of the subject's ability to sit, stand, and ambulate (e.g., walking, running, and climbing stairs). The assessment was made on an 8-point Likert scale (0 to 7), with 0 denoting normal functioning and 7 as the most severe impairment.

    Measured: 12 Weeks Treatment Duration

  5. Change From Baseline to Week 12 in Rett Syndrome Clinician Rating of Ability to Communicate Choices (RTT-COMC)

    Clinical assessment of the subject's ability to communicate their choices or preferences, which can include the use of nonverbal means such as eye contact or gestures. The assessment is made on an 8-point Likert scale (0-7) with 0 denoting normal functioning and 7 the most severe impairment.

    Measured: 12 Weeks Treatment Duration

  6. Change From Baseline to Week 12 in Rett Syndrome Clinician Rating of Verbal Communication (RTT-VCOM)

    Clinical assessment of the subject's ability to communicate verbally (e.g. words and phrases). The assessment is made on an 8-point Likert scale (0-7) with 0 denoting normal functioning and 7 the most severe impairment.

    Measured: 12 Weeks Treatment Duration

  7. Change From Baseline to Week 12 in Clinical Global Impression-Severity (CGI-S)

    A 7 point scale that rates the severity of the subject's illness at the time of assessment, relative to the clinician's experience with subjects who have the same diagnosis. A subject is assessed on severity of illness at the time of rating: 1, normal, not at all ill; 2, borderline ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

    Measured: 12 Weeks Treatment Duration

  8. Change From Baseline to Week 12 in Rett Syndrome Caregiver Burden Inventory (RTT-CBI) Total Score (Items 1-24)

    The Rett Syndrome Caregiver Burden Inventory (RTT-CBI) scale is intended to directly address caregiver burden and indirectly assess the significance of treatment effects on function in the context of activities of daily living. Ratings are on a 5-point Likert scale including: 0-never; 1-rarely; 2-sometimes; 3-frequently and 4-nearly always. As in the original Caregiver Burden Inventory, the RTT-CBI has 24 negatively worded items (items 1 through 24) yielding a total score up to 96. The RTT-CBI the range is 0 to 96 and a higher score represents a worse outcome.

    Measured: 12 Weeks Treatment Duration

  9. Change From Baseline to Week 12 in Overall Quality of Life Rating of the Impact of Childhood Neurologic Disability Scale (ICND)

    The overall quality of life of the subject is also rated by responding to the following: "Please rate your child's overall 'Quality of Life' on the scale below. Choose the number which you feel is best and circle it." The choices range from 1 ("Poor") to 6 ("Excellent").

    Measured: 12 Weeks Treatment Duration

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Nov 2019
  2. Study start6 Nov 2019
  3. Primary completion28 Oct 2021
  4. Study completion28 Oct 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
187 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04181723
Sponsor's protocol ID
ACP-2566-003
Status last verified
Apr 2024
First submitted
26 Nov 2019
Last updated
8 Apr 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Darwish M, Passarell J, Youakim JM, Bradley H, Bishop KM. Exposure-Response Efficacy Modeling to Support Trofinetide Dosing in Individuals with Rett Syndrome. Adv Ther. 2024 Apr;41(4):1462-1480. doi: 10.1007/s12325-024-02796-y. Epub 2024 Feb 16.

    PubMed 38363467
  • Parent H, Ferranti A, Niswender C. Trofinetide: a pioneering treatment for Rett syndrome. Trends Pharmacol Sci. 2023 Oct;44(10):740-741. doi: 10.1016/j.tips.2023.06.008. Epub 2023 Jul 16.

    PubMed 37460385
  • Neul JL, Percy AK, Benke TA, Berry-Kravis EM, Glaze DG, Marsh ED, Lin T, Stankovic S, Bishop KM, Youakim JM. Trofinetide for the treatment of Rett syndrome: a randomized phase 3 study. Nat Med. 2023 Jun;29(6):1468-1475. doi: 10.1038/s41591-023-02398-1. Epub 2023 Jun 8.

    PubMed 37291210
  • Neul JL, Percy AK, Benke TA, Berry-Kravis EM, Glaze DG, Peters SU, Jones NE, Youakim JM. Design and outcome measures of LAVENDER, a phase 3 study of trofinetide for Rett syndrome. Contemp Clin Trials. 2022 Mar;114:106704. doi: 10.1016/j.cct.2022.106704. Epub 2022 Feb 8.

    PubMed 35149233

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Trofinetide in people with Rett Syndrome, run by ACADIA Pharmaceuticals Inc. at 21 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Apr 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rett Syndrome Behaviour Questionnaire (RSBQ) Total Score - Change From Baseline to Week 12 (time frame: Baseline and Week 12). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04181723, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Apr 2024.

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